CN101677812A - Surgical device and using method thereof - Google Patents
Surgical device and using method thereof Download PDFInfo
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- CN101677812A CN101677812A CN200880014088A CN200880014088A CN101677812A CN 101677812 A CN101677812 A CN 101677812A CN 200880014088 A CN200880014088 A CN 200880014088A CN 200880014088 A CN200880014088 A CN 200880014088A CN 101677812 A CN101677812 A CN 101677812A
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/148—Probes or electrodes therefor having a short, rigid shaft for accessing the inner body transcutaneously, e.g. for neurosurgery or arthroscopy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1402—Probes for open surgery
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00053—Mechanical features of the instrument of device
- A61B2018/00059—Material properties
- A61B2018/00071—Electrical conductivity
- A61B2018/00083—Electrical conductivity low, i.e. electrically insulating
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00434—Neural system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00434—Neural system
- A61B2018/0044—Spinal cord
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
- A61B2018/00619—Welding
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00696—Controlled or regulated parameters
- A61B2018/00702—Power or energy
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00636—Sensing and controlling the application of energy
- A61B2018/00773—Sensed parameters
- A61B2018/00875—Resistance or impedance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B2218/00—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2218/001—Details of surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body having means for irrigation and/or aspiration of substances to and/or from the surgical site
- A61B2218/002—Irrigation
Abstract
The invention provides a kind of surgical device and method of handling tissue.In a device embodiment, present invention resides in the bipolar electrosurgical device that has radio-frequency power and handle tissue during from fluid that the distal portions of device provides simultaneously, this device comprises the disc far-end.In a method embodiment, present invention resides in the method for handling tissue in the spinal operation with blood vessel, this method comprises with surgical device the part of blood vessel is pressed against the support ridge rod structure, so that the compression section of blood vessel to be provided, and fully heat the compression section of blood vessel with surgical device, stop the blood flow intravascular to remove the back from blood vessel at surgical device.
Description
The cross reference of related application
The present invention requires the U.S. Provisional Application series number No.60/896 of proposition on March 23rd, 2007,768 priority, and it is taught in this and is incorporated herein by reference.
Technical field
The present invention relates to a kind of surgical device, system and method that in operation, particularly open surgery and micro-wound surgical operation, is used on the tissue such as laparoscopic surgery.
Background technology
Such as the dry terminal electro-surgical device of electric cautery pen processed tissue temperature is risen to significantly and be higher than 100 ℃, cause that tissue dewatering, tissue adhere on the electrode, the tissue perforation, form carbonization and produce smog.
In addition, some surgical device can not use in narrow surgery space too greatly and/or be invalid simply in handling tissue (such as suppressing loss of blood).
Recently, developed fluid auxiliary electrical surgical device, it adopts saline to be suppressed at undesired effect in the organized processing process, adheres to, produces smog and form carbonization such as tissue dewatering, electrode.But too many saline can provide too many electrical dissipation and cooling at the interface in electrode-tissue.This has reduced the temperature of processed tissue, can cause the tissue temperature that is used for organized processing that need the longer processing time obtain to wish conversely.Because the fast as far as possible process that undergos surgery is favourable to patient, doctor and hospital, so for the surgeon, the long processing time is undesirable.
Consider the problems referred to above, need the apparatus and method of the problem of the aforementioned care of solution.
Summary of the invention
In one embodiment, the invention provides a kind of electrosurgery unit, to provide in check radio-frequency power and FLUID TRANSPORTATION to handle tissue to the electrosurgery hand-held device.Described equipment comprises the radio-frequency signal generator of delivering RF power, can select the radio-frequency power levels from the radio-frequency power of radio-frequency signal generator; Pump, described pump conveyance fluid; Filling apparatus arrives hand-held device with fluid perfusion; Control system, with the fluidic flow of the control of the functional relationship between described radio-frequency power levels and the fluid flow by the pump conveying, the increase of described functional relationship response radio-frequency power and increase fluid flow, and reducing of radio-frequency power levels of response and reduce fluid flow; And the fluid flow selector, it changes the functional relationship between described radio-frequency power levels and the described fluid flow.
In another embodiment, the invention provides a kind of bipolar electrosurgical device of handling tissue.This device comprises handle and from the bar of described handle to remote extension, described bar is to become inflexible relation to support the distal portions of described device with described handle.The distal portions of described device ends at the far-end that comprises the disc far-end.Described disc far-end comprises first semicircular electrode and second semicircular electrode.Described device also comprises fluid supplying passage that can be connected to fluidic fluid source and at least one fluid issuing that is communicated with described fluid supplying passage fluid.
In another embodiment, the invention provides a kind of method of in spinal operation, handling tissue with blood vessel, this method comprises with surgical device the part of described blood vessel is pressed the support ridge rod structure, so that the compression section of described blood vessel is provided, and fully heat the described compression section of described blood vessel with surgical device, so that remove the inaccessible described blood vessel in back from described blood vessel at described surgical device.In certain embodiments, described support ridge rod structure comprises vertebra, more particularly, comprises the vertebral body of vertebra.
In another embodiment, the invention provides a kind of method of in operation, handling tissue with blood vessel, this method comprises with surgical device the part of described blood vessel is pressed bone structure, so that the compression section of described blood vessel is provided, and fully heat the described compression section of described blood vessel with surgical device, so that remove the inaccessible described blood vessel in back from described blood vessel at described surgical device.
In another embodiment, the invention provides a kind of electrical power surgical device that uses in operation process, this device comprises the aperture that is formed in the device; Have the button that triggers described device in the aperture, described aperture is limited by the perisporium around described button; Between described button and the described perisporium close clearance is arranged, described close clearance is open to the stream of the fluid in the operation process, and described fluid comprises blood; And described button has next-door neighbour at least one side around the described perisporium of described button, is formed with at least one aperture at least one side of described button, so that stop described button to stick together by blood and described perisporium.
Be appreciated that the concrete feature of describing among these embodiment the device, equipment, the system and method that provide can be provided all fall into scope of the present invention in several embodiment.
Description of drawings
Fig. 1 is the front view of an embodiment of system of the present invention, and it has the electrosurgery unit of fluid source and the combination of hand-held electro-surgical device;
Fig. 2 is the front perspective view of the electrosurgery unit of Fig. 1;
Fig. 3 is the rearview of the electrosurgery unit of Fig. 1;
Fig. 4 is the RF power output P that is used for the electrosurgery unit of Fig. 1
0Curve chart with the impedance Z relativeness;
Fig. 5 is that to be illustrated on the Y-axis with cubic centimetre per minute (cc/min) be brinish fluid flow Q (the high Q of unit
H, middle Q
MWith low Q
L) and on X-axis watt being the RF power setting P of unit
sBetween the curve chart of three mutual relation;
Fig. 6 illustrates how processing RF power setting P of electrosurgery unit
sWith fluid flow Q is set
H, Q
MOr Q
LBlock diagram with control pump speed;
Fig. 7 is the assembling isometric view according to exemplary electrical surgical device of the present invention;
Fig. 8 is under the situation that handle takes off, the isometric view of the intraware of handle;
Fig. 9 is the side view of handle portion of the device of Fig. 7 of being fitted together with each component groups;
Figure 10 is the button of device of Fig. 7 of being fitted together with each component groups and the enlarged side view of handle portion;
Figure 11 is the exploded view of distal portions of the device of Fig. 7;
Figure 12 is the amplification longitdinal cross-section diagram of distal portions of the device of Fig. 7;
Figure 13 is the amplification longitdinal cross-section diagram according to the distal portions of Alternative exemplary electro-surgical device of the present invention;
Figure 14 is the amplification longitdinal cross-section diagram according to the distal portions of Alternative exemplary electro-surgical device of the present invention;
Figure 15 is the isometric view according to the distal portions of Alternative exemplary electro-surgical device of the present invention;
Figure 16 is the amplification longitdinal cross-section diagram of distal portions 16-16 along the line of the device of Figure 15;
Figure 17 is the distal portions of device of Fig. 7 and the enlarged diagram of tissue;
Figure 18 is the enlarged diagram that the distal portions of the device of Fig. 7 presses tissue;
Figure 19 is the enlarged diagram that the distal portions of the device of Fig. 7 is used to handle tissue; With
Figure 20 is that the distal portions of device of Fig. 7 is from the enlarged diagram of the tissue displacement handled.
The specific embodiment
In whole explanation, run through several accompanying drawings, identical Reference numeral and letter representation corresponding structure.And any special characteristic of specific exemplary embodiment can suitably be applied to any other exemplary embodiment of this description.In other words, the feature between each exemplary embodiment described here can suitably be exchanged, and is not exclusive.From description, should know that using of term " far-end " and " near-end " is to be reference with the user that installs, rather than be reference with patient.
Device, the system and method that is used for handling tissue that the invention provides disclosed herein at surgical procedures.These inventions shrink, condense by for example vasoconstrictive inner chamber (for example vein, tremulous pulse) for hope and seal tissue in case the process of hemostasis liquid stream mistake is particularly useful.
Referring now to description of drawings the present invention, Fig. 1 illustrates the front view of an embodiment of system of the present invention, and it has the electrosurgery unit of combining with fluid source 22 and hand-held electro-surgical device 30 14.Fig. 1 illustrates the movable go-cart 2 with underframe 4, and this underframe 4 is provided with four wheels 6 of convenient transportation.The vertical supporting member 8 of underframe 4 carryings, this supporting member 8 comprises the hollow circle tube post, storage basket 10 can be fixed on this post, is used for the unitary user's manual of store electricity surgery and other additional obsolete device.In addition, supporting member 8 carrying platforms 12, this platform 12 comprises the pedestal platform, so that be provided for placing smooth, the stable surface of electrosurgery unit 14.
As shown in the figure, go-cart 2 also comprises fluid source bolster stake 16, slides up and down, uses afterwards the dog screw fix in position in supporting member 8, the height of adjustable body source bolster stake 16 by making bolster stake 16.Have horizontal support member 18 at the top of fluid source bolster stake 16, the end of this horizontal support member 18 is provided with ring 20, so that be provided for carrying the suspension hook of fluid source 22.
Get back to Fig. 1, fluid source 22 comprises the fluid bag, and after bag was positioned at the needle-penetration at place, drip chamber 26 ends, fluid 24 flowed out through drip chamber 26 from bag.Afterwards, fluid 24 flows to hand-held electro-surgical device 30 through flexible delivery 28.Preferably, fluid delivery tube 28 is made of polymeric material.
As shown in Figure 1, fluid delivery tube 28 is through pump 32.As shown in the figure, pump 32 comprises peristaltic pump, more specifically, comprises rotary peristaltic pump.When using rotary peristaltic pump, by raising in a known manner and reducing pump head portion and the part of carrier pipe 28 is loaded in the pump head portion.As illustrating best among Fig. 6, fluid 24 transmits in pipe 28 by the contraction wave that normally mechanically produces by rotation pressure roller 57 on carrier pipe 28 outsides, and wherein said pressure roller 57 presses against on the platform support 58 off and on rotating and will manage 28 on the driving shaft 55.Perhaps, pump 32 can comprise linear peristaltic pump.When using linear peristaltic pump, fluid 24 is by managing normally transmitting in carrier pipe 28 by the contraction wave that a series of compressions refer to or compression pad mechanically produces on 28 outsides, and wherein said a series of compressions refer to or compression pad will be managed 28 successively and is expressed on the support member.Peristaltic pump is usually preferably as electromechanical power shifter, here by motor-driven roller contacting with fluid 24 not, thereby reduces casual contamination of heavy.
In a preferred embodiment, fluid 24 comprises saline, more preferably, comprises common (physiology) saline.Although the description here can be with the reference of saline as fluid 24, other conductor fluid can be used for the present invention.
Though preferred conductor fluid, it more obviously is that fluid 24 also can comprise non conducting fluid that further this description of reading will become.The use of non conducting fluid is preferred not as conductor fluid, but, the use of non conducting fluid still provides some advantage in the use of fully eliminate fluid and dried electrode, comprise for example reducing on the electrode that tissue adheres to device 30 and electrode and/or organize refrigerative generation.Therefore, comprise the use of non conducting fluid, deionized water for example, also within the scope of the invention.
As shown in Figure 1, electro-surgical device 30 is connected to electrosurgery unit 14 by cable 34, and this cable 34 comprises a plurality of electric insulated conductors and at least one plug 36 of its end.Electrosurgery unit 14 provides radio frequency (RF) energy/power by cable 34 to electro-surgical device 30.As shown in Figure 2, the plug 36 of receiving system 30 in the plug receptor 38 of electrosurgery unit 14 is so that make device 30 be electrically connected with electrosurgery unit 14.Preferably, fluid delivery tube 28 is set to the part of cable 34 and is shaped with electric insulated formation by the plastics co-extruded.
Fig. 2 illustrates the front panel of electrosurgery unit 14.On and off switch 42 is used for opening and closing electrosurgery unit 14.After opening electrosurgery unit 14, RF power setting display 44 is used to show watt being the RF power setting numerical value of unit.Preferably, the power setting display comprises liquid crystal display (LCD).In addition, display 44 is used to show mistake, and in this case, display 44 will illustrate " Err " and and alternately flicker of particular error code numerical value.
The RF power selector comprises RF power setting switch 46a, the 46b that is used to select the RF power setting.Push switch 46a increases the RF power setting, and push switch 46b then reduces the RF power setting.The output of RF power can be set in 20 to 100 watts scope, and increment is 5 watts; And in 100 to 200 watts the scope, increment is 10 watts.In addition, electrosurgery unit 14 comprises RF power trigger display 74, and this display comprises the display lamp of lighting when RF power is triggered.Switch 46a, 46b can comprise diaphragm switch.
Except having RF power setting display, electrosurgery unit 14 also comprises fluid flow setting display.The flow set display comprises three display lamp 50a, 50b and 50c, and the first lamp 50a sets corresponding to low fluid flow, the second lamp 50b corresponding in (centre) fluid flow set, the 3rd lamp 50c sets corresponding to high flow capacity.When selecting fluid flow to set, one of these three display lamps will be lighted.
The fluid flow selector comprises flow set switch 52a, 52b and 52c, is used for selecting or switching flow set.Three push switches be provided with the first switch 52a that sets corresponding to low fluid flow, corresponding in the second switch 52b that sets of (centre) fluid flow and the 3rd switch 52c that sets corresponding to high flow capacity.Push one of three switches select low accordingly, in (centre) or high flow capacity set.If manually do not select to set, in selecting so automatically or middle flow set as default settings.Switch 52a, 52b and 52c can comprise diaphragm switch.
Before the beginning surgical procedures, hope be with fluid 24 device for casting 30.Perfusion it is desirable to stop the RF power trigger under the situation that does not have fluid 24.Perfusion switch 54 is used for starting with fluid 24 device for casting 30.In case push switch 54, the open operation of pump 32 continue predetermined amount of time with device for casting 30.After this time period finished, pump 32 cut out automatically.When the perfusion of device 30 starts, comprise that the perfusion display 56 of display lamp is lighted in the perfusion cycle.
When hand switch 162 (as shown in Figure 1) on passing through device 30 or sufficient switch (not shown) triggered the RF power from electrosurgery unit 14, the bipolar trigger scope 74 on the front panel was lighted.Pull out drawer 76 and be positioned at electrosurgery unit 14 belows, the user of electrosurgery unit 14 can find the user's manual of short form at there.
Fig. 3 illustrates the rear board of electrosurgery unit 14.The rear board of electrosurgery unit 14 comprises speaker 60 and volume control knob 62, so that adjust the volume of the sound (RF power trigger sound) that will hear when the RF power trigger.The volume of RF power trigger sound increases by the knob that turns clockwise, and reduces by being rotated counterclockwise knob.But electrosurgery unit 14 prevents that this sound is quiet fully.
The rear board of electrosurgery unit 14 also comprises and is used for main power cable is connected to the power cable receptor 64 of electrosurgery unit 14 and uses suitable cable electrosurgery unit 14 to be connected to the isoelectric level ground wire connector 66 on ground.Rear board also comprises removable block 68, and this block 68 is used for being connected to the installation of bipolar sufficient combined socket and switch of the inside foot on-off circuit of electrosurgery unit 14, thereby except installing 30 hand switch, RF power also can be by sufficient switch triggering.In addition, rear board also comprises fuse drawer 70, and this fuse drawer 70 holds two the extra fuses consistent with line voltage.At last, rear board comprises nameplate 72, and this nameplate 72 can provide model, serial number, normal line voltage, frequency, electric current and the fuse rating information such as electrosurgery unit 14.
The RF power curve of output of electrosurgery unit 14 has been shown among Fig. 4.Impedance Z is a unit with ohm, and output P is shown on X-axis
0Watt to be unit, on Y-axis, illustrate.In an illustrated embodiment, bipolar electrosurgical power (RF) is set at 200 watts.As shown in the figure, for 200 watts RF power setting P
s, need only impedance Z and be in, so output P by 30 ohm Low ESR with by between 125 ohm the high impedance
0To keep power P with setting RF
sConsistent.As shown in the figure, in the impedance Z that is lower than 30 ohm, output P
0To descend with the Low ESR slope.As shown in the figure, in the impedance Z that is higher than 250 ohm, output P
0Also will descend with the high impedance slope.
Therefore and default fluidic throughput by the pump discharge electrosurgery unit 14 is configured to also make that setting these two input variables based on RF power setting and fluid flow preset pump speed, and.Figure 5 illustrates on the Y-axis with cubic centimetre per minute (cc/min) is watt being the RF power setting P of unit on the fluid flow Q of unit and the X-axis
sBetween relation.This relation is designed to stop undesired effect, adheres to, produces smog and form carbonization such as tissue dewatering, electrode, provides simultaneously corresponding to RF power setting P
sFluid flow Q, this flow is not too large and too many fluid and relevant electrical dissipation and electrode-tissue cooling at the interface are provided.Though be not attached to particular theory, but for fluid flow how interact with radio-frequency power, from the more detailed discussion of the heat transfer pattern of tissue, the boiling of fluidic part and various control strategies, can in the open No.2001/0032002 of the U.S. that announce October 18 calendar year 2001, find, and the disclosure No.2001/0032002 has transferred assignee of the present invention, at this it is incorporated herein by reference with the degree of unanimity in full.
As shown in the figure, electrosurgery unit 14 has been configured to for corresponding respectively to Q
L, Q
MAnd Q
HLow, in and Senior Three fluid flow set each, fluid flow Q is along with RF power setting P
sIncrease and linear increasing.On the contrary, electrosurgery unit 14 has been configured to for corresponding respectively to Q
L, Q
MAnd Q
HLow, in and Senior Three fluid flow set each, fluid flow Q is along with RF power setting P
sReduce and linear the minimizing.As shown in the figure, by changing exemplary ratios constant, Q
L, Q
MAnd Q
HCan be expressed as RF power setting P
sFunction, as follows:
Q
L＝0.1×P
s
Q
M＝0.1286×P
s
Q
H＝0.1571×P
s
Fig. 6 shows how processing RF power setting P of electrosurgery unit 14
sSet Q with fluid flow
L, Q
MOr Q
HInput so that the control pump speed and the therefore example block diagram of the control fluid throughput of discharging by pump 32.As shown in the figure, the RF power setting P of user selection
sAnd low, neutralization is high (corresponding to Q
L, Q
MAnd Q
H) fluid flow set in any input value, and trigger perfusion functional, be input to electrosurgery unit 14 by pushing the switch corresponding that is arranged on electrosurgery unit 14 front panels with these parameters.
As shown in Figure 6, RF power setting switch 46a, 46b, flow set switch 52a, 52b, 52c and perfusion switch 54 be the part of display module 40 preferably all, and this display module 40 preferably includes to receive and enters the printed circuit board (PCB) of the input in the electrosurgery unit 14.
RF power, fluid flow and the dabbling input value of user selection are transferred to primary module 43 by respective input signals 41 then, this primary module 43 preferably includes printed circuit board (PCB), and printed circuit board (PCB) comprises computer chip 45, radio-frequency signal generator 47 and pump controller 48.As shown in the figure, display module 40 and primary module 43 and other assembly power module 49 received powers from also comprising printed circuit board (PCB).
Computer chip 45 preferably includes microprocessing unit, memorizer and I/O control unit.By this way, the functional relationship between radio-frequency power levels and the fluid flow can be stored in the memorizer of computer chip 45.Though functional relationship can be stored with the form of previous equations, yet they also can be stored as the numbered strong point as a database look-up part.
As shown in the figure, process chip 45 receives and handles input signal 41.More specifically, for example, according to receive corresponding to Q
L, Q
MOr Q
HThe input signal set of fluid flow, computer chip 45 can at first determine to use top which equation.After determining to use which equation, computer chip 45 can be used this relation based on the radio-frequency power levels of selecting then, is identified for the output of the fluidic flow of self-pumping 32.Determined this output, computer chip 45 sends output signal 51 and 53 to radio-frequency signal generator 47 and pump controller 48 respectively then, and this output signal 51 and 53 corresponds respectively to the radio-frequency power levels of selection and the fluid flow output that comes self-pumping 32 of calculating.Afterwards, pump controller 48 speed that makes the input voltage 59 of the pump motor 61 of driving shaft 55 rotation come control pump driving shaft 55 by control.Exemplary electrosurgery unit 14 more detailed figure can find in the open No.2006/0149225 of the U.S. that on July 6th, 2006 announced, and No.2006/0149225 has transferred assignee of the present invention, at this it is incorporated herein by reference with the degree of unanimity in full.
As shown in Figure 7, exemplary bipolar electrosurgical device 30a comprises single fixed arm 100, and this list fixed arm 100 is made of hollow bar 102 inflexible, self-supporting.As shown in the figure, bar 102 preferably has the distal portions 106 of knuckle with better finder 30a in using at it.Bar 102 preferably is made of metal tube, more preferably is made of heavy wall subcutaneous injection stainless steel tube.By this way, bar 102 has enough rigidity keeping its form in device 30a uses, and can flexing or obviously crooked, and with 104 one-tenths rigid relation ground supports of proximal handle distal portions 106.In other embodiments, bar 102 can be made of non-conducting material, such as polymeric material or composite.
In this embodiment, the cable 34 of device 30a comprises three covered wire 34a, 34b, the 34c (as shown in Figure 8) that can be connected to electrosurgery unit 14 by three (public affairs) pin connector 37a, 37b, 37c.Pin connector 37a, 37b, 37c fit together each with line 34a, 34b, 34c and line conductor 35a, 35b, 35c in public jack shell 36.As in Fig. 8, illustrating best, Fig. 8 shows the intraware of the situation lower handle 104 that removes at handle 104, line conductor 35a preferably is directly connected to the line conductor 158a of covered wire 160a by welding, as following discussed in detail, the far-end of this covered wire 160a is connected to electrode 114a.Also as shown in Figure 8, the line conductor 35b of line 34b at first connected by hand switch assembly 162 before preferably being connected by welding to the line conductor 158b of covered wire 160b, and as following discussed in detail, the far-end of this covered wire 160b is connected to electrode 114b.At last, the line conductor 35c of line 34c is connected to hand switch assembly 162, the circuit that is used for switch module with box lunch is by pressing of hand switch pressing button 164 when closed, notice electrosurgery unit 14 provides power, and wherein this hand switch pressing button 164 preferably is made of the rigid polymer such as polyacetals.
Except in Fig. 8, switch module 162 is also shown in Fig. 9 and 10.As illustrating best among Figure 10, switch module 162 comprises pressing button 164 and has the dome switch 172 of two electrical contacts.Contact preferably includes with stacked relation and is arranged on upper and lower contact on the platform 174.Preferably, upper contact head comprises cheese structure, and is stacked and be separated from each other with smooth following contact.Preferably, when button 164 was in not pressing position, by the dome structure of upper contact head, contact was separated from each other, and therefore produces the disconnection control circuit with respect to switch 172.But when the top of button 164 is pressed and upper contact head when correspondingly being pressed in the depressing position, upper contact head contacts with following contact, thus closed hand switch control circuit.The appearance of following closed control circuit is detected by electrosurgery unit 14, and electrosurgery unit 14 counter electrode 114a, 114b provide power then.
When pressing force when upper contact head is eliminated, as the result of its elasticity or elastic memory, contact turns back to its dome position of not depressing, so button 164 returns its not depressing position and disconnect the hand control circuit once more.The appearance that then disconnects control circuit is detected by electrosurgery unit 14, and electrosurgery unit 14 stops counter electrode 114a, 114b then provides power.Being described in more detail of the figure of switch module 162 and operation can be found in the open No.2005/0090816 of the U.S. that on April 28th, 2005 announced, and No.2005/0090816 has transferred assignee of the present invention, thereby it is incorporated herein by reference at this on the degree of unanimity in full.
In the use of device 30a, blood and concretion may be deposited in the close clearance 170 between button 164 and the handle 104.As illustrating best among Figure 10, button 164 is positioned at the aperture 166 that is limited by perisporium 168 of handle 104.As shown in the figure, the side of button 164 comprises a plurality of apertures 163.The surface area with the contiguous sidewall 165 of the perisporium 168 of handle portion 104a, 104b has been reduced on the button 164 in aperture 163.Therefore owing to reduced the surface area of the sidewall 165 of button 164, so when pressing force when button 164 is cancelled, button 164 is not easy to adhere and be attached to handle portion 104a, 104b owing to blood and concretion.
As illustrating best in Figure 11, device 30a has the disc far-end that comprises two bipolar electrode 114a, 114b.Comprise hull outside divide 112 and enclosure interior divide 116 insulation shell assembly that electrode 114a, 114b are fixed to device 30a.Hull outside divide 112 and enclosure interior divide 116 to comprise electrically insulating material, preferred polymers, and more preferably fluorinated polymer are such as polytetrafluoroethylene (PTFE).Except the insulating effect that electrifies, preferably polytetrafluoroethylene is because its hydrophobicity and therefore stop on it in surgical operation and fluid occurs provides good impedance, and is provided for reducing and organizes adherent low-friction coefficient.
As shown in figure 12, hull outside divides 112 to make electrode 114a, 114b and metallic rod 102 electric insulations.Shown in Figure 11 and 12, hull outside divides 112 to comprise near-end cylindrical portions may 118 and far-end cylindrical portions may 120.Near-end cylindrical portions may 118 has the external diameter more smaller than far-end cylindrical portions may 120, and this produces rim 122 between the two.In order to assemble, near-end cylindrical portions may 118 is provided for dividing 112 coupling parts that are connected to bar 102 with hull outside.As shown in figure 12, the outer diameter configuration of near-end cylindrical portions may 118 becomes to extend in the inner chamber 124 of bar 102, and cooperates with the internal diameter of bar 102, and rim 122 contacts with the far-end 110 of bar 102.The external diameter of near-end cylindrical portions may 118 can be configured to be slidingly matched with formation with the internal diameter cooperation of bar 102, binding agent or other bonding agent will be applied between cylindrical portions may 118 and the bar 102 in this case, so that provide fixedly connected, perhaps form the pressure (interference) that does not need to use independent bonding agent and cooperate.
Shown in Figure 11 and 12, enclosure interior divides 116 by being electrically insulated from each other between electrode 114a, the 114b providing spacer to make between electrode 114a, the 114b.Particularly, enclosure interior divides 116 to comprise the far-end isolated part 126 that is arranged between electrode 114a and the 114b.In order to assemble, enclosure interior divides 116 also to comprise and be used for dividing 116 to be connected to hull outside and to divide 112 near-end cylindrical portions may 128 enclosure interior.As shown in figure 12, the outer diameter configuration of near-end cylindrical portions may 128 becomes to extend to hull outside divides in 112 the endoporus 130 and with the diameter in hole 130 and cooperates, and hull outside is divided 112 far-end cylindrical portions may 120 to provide around enclosure interior and divided 116 and the axle collar of electrode 114a, 114b.The external diameter of near-end cylindrical portions may 128 can be configured to cooperate with formation with the diameter in hole 130 and be slidingly matched, binding agent or other bonding agent will be applied to cylindrical portions may 128 and hull outside is divided between 112 in this case, so that provide fixedly connected, perhaps form the pressure (interference) that does not need to use independent bonding agent and cooperate.
Except foregoing, as in Figure 11, illustrating best, enclosure interior divides 116 near-end cylindrical portions may 128 to be provided with two relative flat surfaces 132a, 132b, with divide in hull outside 112 and enclosure interior produce two local gap 134a, 134b between dividing 116, as shown in figure 12, lower limb 136a, the 136b of electrode 114a, 114b can pass this local gap 134a, 134b extends to is connected with line conductor 158a, the 158b of covered wire 160a, 160b.
Turn back to Figure 11, lower limb 136a, the 136b of electrode 114a, 114b from the far-end that is positioned at device 30a and two semicircular electrode part 138a, 138b with identical size and dimension to proximal extension.By this way, the electric current density that is presented relative to each other by electrode is with basically identical.As shown in the figure, semicircular electrode partly is mirror images of each other, and each all comprises approximately circular half shape.Electrode 114a, 114b preferably include conducting metal, and this conducting metal is the metal of preferred corrosion resistance also.Preferred material is a rustless steel.Other suitable metal comprises titanium, gold, silver and platinum.
As shown in figure 12, the far-end of device 30a is planar (smooth), and perpendicular to the longitudinal axis of bar 102.In other embodiments, as shown in the figure, for example, in Figure 13, the far-end of device 30b can protrude.In other embodiments, as shown in the figure, for example, in Figure 14, the far-end of device 30c can be recessed into.
Turn back to Figure 12, enclosure interior is divided 116 linear blind hole 140 and the counterbores 142 that also comprise the portrait orientation that is positioned at cylindrical portions may 128 centers.As shown in the figure, the outer diameter configuration of fluid delivery tube 150 one-tenth extends in the counterbore 142 and with the diameter of counterbore 142 and cooperates, and the far-end of pipe contacts with the bottom of counterbore.The external diameter of fluid delivery tube 150 can be configured to cooperate with the diameter of counterbore 142 to form presses (interferences) cooperation, so that provide fixedly connected to provide fluid delivery tube 150 and enclosure interior to divide fluid-tight between 116 with the use of binding agent or other bonding agent.
Except blind hole 140 and counterbore 142, enclosure interior divides 116 also to be included in the far-end of blind hole 140 and blind hole 140 square crossings and to extend through the linear through hole 144 of cylindrical portions may 128.As shown in the figure, blind hole 140 and through hole 144 are communicated with inner chamber 152 fluids of the fluid delivery tube 150 of terminal in the fluid communication with cavity 29 of fluid delivery tube 28.By this way, the T shape fluid flowing passage of the fluid 24 that provides from fluid delivery tube 28 and 150 is provided for blind hole 140 and through hole 144.
As shown in figure 11, for the fluid passage bleeder 30a of fluid from providing by through hole 144 is provided, two through hole 146a, 146b that hull outside divides 112 cylindrical portions may 120 to be provided with to align with through hole 144 and provide fluid issuing for fluid.As shown in the figure, through hole 144 extend pasts and far-end isolated part 126 parallel enclosure interior divide 116.
As illustrating best in Figure 11, through hole 146a, 146b are arranged on and are used for hull outside and divide 112 electrically insulating material, and are positioned at device 30a and go up on the distal portions near the device far-end.By this way, through hole 146a, 146b are configured to stop up between the holdout device 30a operating period.In other words, because hull outside divides 112 to be nonconducting, and,, tissue and blood knot thing divide 112 so being not easy to be adhered to hull outside not as electrode.Equally, go up on the distal portions near the device far-end because through hole 146a, 146b are positioned at device 30a, thus through hole 146a, 146b be not easy directly to be exposed to be usually located at device 30a far-end the blood zone arranged.
Under the blocked situation of through hole 146a, 146b and through hole 144, through hole 146a, 146b and through hole 144 can insert one of through hole 146a, 146b and through hole 144, pin nail and extend fully through device 30a and pin nail and go out from other hole and dredge and clean by pin being followed closely the shape structure.By this way, the material that stops up through hole 146a, 146b and through hole 144 can and therefrom be removed by the pushing of pin nail.
Also as shown in figure 11, through hole 146a, 146b are positioned at the relative both sides of device 30a.Through hole 146a is set at the bight of electrode 114a 148a adjacent with electrode 114a and the most approaching, adjacent with electrode 114b and the most approaching at the bight of electrode 114b 148b.Through hole 146b is set at the bight of electrode 114a 149a adjacent with electrode 114a and the most approaching, adjacent with electrode 114b and the most approaching at the bight of electrode 114b 149b.By this way, the most suitably work in order to make device 30a, fluid can be provided to the fluidic position of needing most of electrode 114a, 114b and tissue (being the bight of electrode and adjacent with it tissue).Equally by this way, be provided to semicircle side perimembranous 151a, the 151b of electrode 114a, 114b from the fluid of through hole 146a, 146b.As shown in figure 12, semicircle perimembranous 151a, the 151b of electrode 114a, 114b are exposed to tissue and circumferentially extend around the major part of device 30a far-end.As shown in the figure, the semicircle perimembranous 151a of electrode 114a extends to bight 149a from the bight 148a of electrode 114a, and the semicircle perimembranous 151b of electrode 114b extends to bight 149b from the bight 148b of electrode 114b.
In other embodiments, shown in Figure 15 and 16, the semicircle side perimembranous 151a, the 151b that are used for electrode 114a, the 114b of device 30d are covered by electrical insulator, this electrical insulator is preferably provided by shell body part 112, handles tissue so that semicircle perimembranous 151a, the 151b of electrode 114a, 114b are not used in.As shown in the figure, semicircle perimembranous 151a, the 151b of electrode 114a, 114b are covered by the annular section of shell body part 112.
In device 30a uses, from the fluid passage connection of fluid 24 through providing of fluid source 22 by each structure.The inner chamber 29 that at first is communicated with carrier pipe 28 from the fluid 24 of fluid source 22.As shown in Figure 8, fluid 24 is supplied in the inner chamber 156 of the size minimizing sleeve pipe 154 in the handle 104 then, enters the inner chamber 152 of the pipe 150 in the inner chamber 124 that is contained in bar 102 then, as shown in figure 12.Fluid 24 enters through hole 144 then from managing 150 inner chamber 152 blind hole 140 of flowing through then, discharges from through hole 146a, 146b.In the present embodiment, use peristaltic pump 32, as shown in Figure 7, the particular pump pipeline section 182 that is designed to operate with peristaltic pump 32 especially can be bonded between the part of carrier pipe 28, and utilizes the fluid line adapter 180 that barb is arranged to be connected to the described part of carrier pipe 28 at its two ends.
Run through and among several embodiment be, be used for the material on electrode 114a, 114b and surface thereof and the relation between the fluid 24 and should make the surface of fluid 24 wetting electrode 114a, 114b.Contact angle θ is that solid is by the quantitative measurement of liquid moistening.Be defined as the angle that the crossing three phase boundary place of liquid, gas and solid is formed by liquid geometrically.According to the thermodynamic behaviour of related material, contact angle θ relates to the interfacial free energy between the three-phase, is provided by following formula:
γ
LVcosθ＝γ
SV-γ
SL
γ wherein
LV, γ
SVAnd γ
SLThe interface energy that refers to liquid/gas, solid/gas and solid/liquid interfaces respectively.If contact angle θ is less than 90 degree, liquid moistening solids in other words.If contact angle is greater than 90 degree, liquid is non-moistening so.Zero contact angle θ represents complete wetting.Therefore contact angle is preferably less than 90 degree.
Bipolar device disclosed herein is used in particular for providing in surgical operation hemostatic the disengaged sealer of organizing.In other words, do not need to clamp tissue with shrink, condense and seal tissue (for example, by pressor collagen and relevant blood vessel (for example tremulous pulse, vein) inner chamber) prevent loss of blood, thus the inhibition blood flow is crossed tissue and outflow from tissue, and ideal tissue hemostasis is provided.More particularly, device can be used for shrinking the blood vessel that cuts off or do not cut off, for example blood vessel of vertebral vein in diskectomy and/or Arterial system at spinal surgery.
Intervertebral disc is the pad that closely is fixed on the fibrous cartilage tissue between the vertebra of spinal column.Intervertebral disc comprises smooth circular bladder, and about one inch of diameter, is made of the tough and tensile fiber adventitia that is called as fibrous ring, round the elastic core that is called vertebral pulp by thick about 0.25 inch.
When stressed, enlargement and herniae may take place in vertebral pulp, and pushing is by the weak spot in the fibrous ring film of intervertebral disc and enter spinal canal.Therefore, nucleus material all or part may be given prominence to by this weak spot, produces perineural compressing, causes pain and can not move.
Must take out from patient body as the part of diskectomy impaired intervertebral disc and subsequently above and below under the vertebral body of the vertebra situation about engaging, device of the present invention for shrink and the blood vessel of seal ridge vertebral vein and/or Arterial system particularly useful.
The vertebral vein system comprises any that centers in four interconnective vein networks of spinal column.These are known to be as vertebra (exterior dura) venous plexus in preceding outer plexus venosus vertebralis (around the system of vertebral body), the outer plexus venosus vertebralis in back (around the system of vertebral process), antecosta vertebra (exterior dura) the venous plexus system of cerebral dura mater length (before the spinal canal to) and the back (arriving the system of dural length behind the spinal canal), after both constitute the exterior dura venous plexus.The vein of outer plexus venosus vertebralis is communicated with the vein of interior plexus venosus vertebralis by the front and rear sections spinal cord/radicular vein of vein between vertebra and each vertebral body joint.
The vertebral artery system comprises the section tremulous pulse of spinal column, supplies the forward and backward radicular arteries of each vertebral body joint.In thoracic vertebra and lumbar regions, after the section tremulous pulse comprises the intercostal that occurs later from large artery trunks, rib down and lumbar arteries.Be fed to the blood section of the being derived from tremulous pulse of spinal column, two networks of this section tremulous pulse supply: supply with vertebra, paraspinal muscle and the spatial bone element of exterior dura for one, another internal network provides nutrition for spinal cord itself.
The section tremulous pulse extends from large artery trunks, hugs the periphery of the vertebral body of vertebra, along with they near neuropore, send that vertebra other coincide (paravertebral anastomose), coincide (pevertebral anastomose) before the vertebra and main dorsal part branch.The skeleton in the aft section of processus transversus vertebrarum back lower place supply vertebra and paraspinal muscle is continued at the ramose back of this main dorsal part.Dorsal part branch sends spinal branches very soon after starting point, supply anterior radicular artery and leading portion pulp artery, spinal artery before the final supply.Spinal branches also is fed to branch vertebral body, cerebral dura mater and posterior radicular artery, at last supply back spinal artery.
In the diskectomy of back, device of the present invention can more particularly be used for before entering intervertebral disc space by the surgeon, vertebra (exterior dura) venous plexus and antecosta vertebra (exterior dura) venous plexus in the vein of the outer plexus venosus vertebralis in sealing back, the back.Perhaps, in the pro-diskectomy, the vein and the section tremulous pulse of outer plexus venosus vertebralis before device of the present invention can more particularly be used for sealing by the surgeon, front and the anterior component of especially contiguous vertebral body.
In diskectomy, blood vessel often is cut open, splits or cuts off.These angiorrbagias, blood can flow into the organized processing position as a result, makes the poorer and prolongation processing procedure of visibility.Method of the present invention can be used for angitomy, split or cut off before this vertebra blood vessel of sealing in case the hemostasis liquid stream lose.This method comprises with surgical device (such as device of the present invention) part of blood vessel is being pressed the support ridge rod structure, so that the compression section of blood vessel is provided, and heat the compression section of blood vessel fully with surgical device, so that make vascular occlusion (for example the contraction by vascular collagen and/or the opposite inner face of inner chamber is welded together to come vasoconstrictive and inner chamber) stop blood flow to cross blood vessel to remove the back from blood vessel at surgical device by the collagen welding.
Support ridge rod structure (vascular pressure leans against on this support ridge rod structure) comprises the vertebra of one or more spinal columns, can also comprise the vertebral body of vertebra.Vertebra can comprise in cervical vertebra, thoracic vertebra or the lumbar vertebra.Except vertebra, supporting construction can also comprise ligament, such as preceding vertical ligament, the vertical ligament in back or intervertebral disc.
According to the type of handling, the support ridge rod structure also can be included in the side direction front side of the vertebral body of the front side of vertebral body of the vertebra that can run in the anterior approach process or vertebra.For posterior approach, the support ridge rod structure also can comprise the side direction rear side of the vertebral body of the rear side of vertebral body of vertebra or vertebra.Preceding road or posterior approach can be the parts of endoscope's spinal operation, peritoneoscope spinal operation or opening spinal operation.
, the rigidity of vertebra and the stability of vertebra, blood vessel can not make the vertebra distortion because can being pressed against on the vertebra.By this way, blood vessel can be compressed, and this moment, the compression section of blood vessel can fully be heated, so that make vascular occlusion at surgical device after blood vessel removes.
The distal portions 106 that Figure 17 shows device 30a (similarly for device 30b-30d) is directed the use how, and the longitudinal axis of its king-rod 102 is directed vertically, and the distal face of device 30a is to the organized processing position.In other embodiments, can be at the longitudinal axis of bar 102 flatly directed or be in vertically and operative installations 30a during any directed between the level.
Figure 17 illustrates device 30a and the tissue 200 before handling.As shown in the figure, tissue 200 comprises blood vessel 220, more specifically, comprises the exterior dura vein.Being ligament 230 below the blood vessel 220, more specifically, is vertical ligament of vertebra.Being vertebra 232 below the ligament 230, more specifically, is the vertebral body of vertebra 232.
Figure 18 shows the device 30a that affacts tissue 200 with sufficient power and pressure, this power and pressure are applied on the device 30a by user, the part of blood vessel 220 is pressed against on the support ridge rod structure, promptly press against on the ligament 230 and vertebra 232 here, so that the compression section of blood vessel 220 is provided.In certain embodiments, device 30a can comprise the feedback mechanism such as power or piezometer measuring device, the user of caution device when this feedback mechanism affacts blood vessel 220 at sufficient power/pressure.In other embodiments, feedback mechanism can comprise the light of triggering.As shown in the figure, electrode 114a, the 114b of device 30a are spaced apart, the tissue surface 202 of adjacent tissue 200, and the distance that electrode 114a, 114b separate is the width that enclosure interior is divided 116 far-end compartment 126.
Figure 19 shows the device 30a in the use, and wherein the fluid 24 of discharging from hole 146a, 146b flow to electrode 114a, 114b to far-end, with surface 202 that tissue 200 is provided and the partial fluid between electrode 114a, the 114b in conjunction with 204.Preferably, fluid 24 engages between electrode 114a, 114b and tissue 200, engages smooth semicircular electrode part 138a, the 138b place of part at perimembranous 151a, 151b and electrode 114a, the 114b of the electrode 114a, the 114b that are positioned at device 30a far-end.Simultaneously, offer tissue 200 and below tissue surface 202, enter tissue 200 at tissue surface 202 places by fluid 24 by the RF electric energy/power shown in the electric field line 206.
Use device 30a fully heats the compression section of blood vessel 220, makes blood vessel 220 part obturations at least, so as to stop blood at device 30a from the blood vessel 220 of flowing through after blood vessel 220 removes.Here be by abundant heating blood vessel 220 with the collagen in the vasoconstrictive 220, thereby the inner chamber 222 of vasoconstrictive 220 and blood vessel 220 is carried out.This also applies sufficient heating by the compression section to blood vessel 220 and pressure is carried out the opposite inner face 224 and 226 of inner chamber 222 is welded (here by the collagen welding) together.
The time that contraction comprises the tissue (such as blood vessel) of type i collagen is depended on temperature usually.For example, type i collagen shrinks when being exposed to about 0.01 second of about 85 ℃ temperature exposure time, when being exposed to about 1 second of about 75 ℃ temperature exposure time, when being exposed to about 10 seconds of about 70 ℃ temperature exposure time and when being exposed to about 15 minutes of about 65 ℃ temperature exposure time.Being used to organize the typical target temperature/time of heating is 75 ℃, 1 second.For convenience, explanation in another way, tissue should fully be heated exactly, with the shrink collagen that (comprises 1 second and 10 seconds) in about 1 second to 10 seconds scope comprising after RF triggers.
Fluid 24 except generator 30a and organize between 200 electricity in conjunction with, the surface 202 of also cooling off and lubricate tissue 200 is so that prevention electrode 114a, 114b adhere to tissue 200.According to the Fluid Volume at device 30a far-end and organized processing end place, fluid can comprise around the single combination of device 30a far-end in conjunction with 204 or be positioned at a plurality of discrete combination on every side of the most close through hole 146a of device, 146b.
For device 30a, fluid engages the conductor fluid bridge also can comprise between electrode 114a, the 114b, and this conductor fluid bridge is arranged on the surface 202 of tissue 200 and the branch road between formation electrode 114a, the 114b.For this situation, a certain amount of RF energy can shift and not enter tissue 200 and actual pass between electrode 114a, 114b by the conductor fluid bridge.The RF energy loss can be slowed down the process of handling tissue.But, for device 30a, have the relative bight 148a, the 148b that lay respectively at electrode 114a, 114b and/or relatively this combination between bight 149a, the 149b may be ideal, this is because because the structure of electrode, and the tissue in contiguous these bights can heat quickly or becomes hotter than other processed organizing.In this case, having fluid in these positions can provide organizing 200 more isostatic heating and processing in conjunction with 204.Therefore, it is desirable to provide the fluid 24 of amount like this from device 30a, make and may heat quickly or the hotter part that becomes than organizing of other processing that the fraction fluid boiling is to dissipate the heat of self-organizing, a certain amount of RF energy of fluid transfer does not enter tissue 200 simultaneously.
Figure 20 shows in blood vessel 220 sealing in case the hemostasis liquid stream is become estranged blood flow and crosses under the situation of this blood vessel from organizing 200 to remove device 30a.
As mentioned above, bipolar devices of the present invention stops tissue dewatering, electrode to adhere to, form carbonization and produces the such undesired effect of smog, does not therefore have the shortcoming identical with the dry end electro-surgical device of prior art.The use of device disclosed by the invention can significantly reduce the loss of blood in the surgical procedures.The minimizing of this loss of blood can reduce or eliminate the needs of blood transfusion, therefore reduces the negative consequences clinically that cost and blood transfusion bring, such as prolonging time of hospitalization.
Though described the preferred embodiments of the present invention, should be appreciated that, under the situation of the scope that does not deviate from the present invention's spirit and claims, can carry out various variations, adaptive change and modification.Therefore scope of the present invention should not determined with reference to above-mentioned explanation, and should with reference to described claim with and four corner of equal value determine.In addition, should be appreciated that claims must not comprise the alleged in the claims the present invention of applicant scope the most widely, perhaps the mode that all needs of the mode that requires of the present invention or feature that all are enumerated only.
All disclosed and patent documentations that the application quotes are incorporated herein by reference on the consistent degree of all purposes in full.
Claims (39)
1. bipolar electrosurgical device is handled tissue under the fluidic situation that has radio-frequency power and provide simultaneously from the distal portions of described device, described device comprises:
The hands handle;
To remote extension, described bar is to become inflexible relation to support the distal portions of described device with described handle from described handle for bar, described bar;
The distal portions of described device ends at the far-end of described device, and the far-end of described device comprises the disc far-end;
Described disc far-end comprises first semicircular electrode and second semicircular electrode;
Fluid supplying passage, described fluid supplying passage can be connected to fluidic fluid source; And
At least one fluid issuing, described at least one fluid issuing is communicated with described fluid supplying passage fluid.
2. device as claimed in claim 1, wherein:
Described first semicircular electrode has circular roughly the first half shape; And
Described second semicircular electrode has circular roughly the second half shape.
3. device as claimed in claim 1, wherein:
Described first semicircular electrode and described second semicircular electrode are mirror images each other.
4. device as claimed in claim 1, wherein:
Described first semicircular electrode has the semicircle perimembranous of first electrode; And
Described second semicircular electrode has the semicircle perimembranous of second electrode.
5. device as claimed in claim 4, wherein:
The described first electrode semi-circular shape perimembranous exposes; And
The described second electrode semi-circular shape perimembranous exposes.
6. device as claimed in claim 4, wherein:
The far-end of described device has circumference; And
The semicircle perimembranous of semicircle perimembranous of described first electrode and described second electrode all centers on the part of described circumference and extends.
7. device as claimed in claim 4, wherein:
The semicircle perimembranous of described first electrode is covered by electrical insulator; And
The semicircle perimembranous of described second electrode is covered by electrical insulator.
8. device as claimed in claim 4, wherein:
Housing is fixed to described device with described first semicircular electrode and described second semicircular electrode; And
The part of described housing covers semicircle perimembranous of described first electrode and the semicircle perimembranous of described second electrode.
9. device as claimed in claim 8, wherein:
The described part that covers the described housing of semicircle perimembranous of described first electrode and the semicircle perimembranous of described second electrode comprises the annular section of described housing.
10. device as claimed in claim 1, wherein:
The distal portions of described device comprises described first semicircular electrode, described second semicircular electrode and the housing that described first semicircular electrode and described second semicircular electrode is fixed to described device.
11. device as claimed in claim 10, wherein:
Described housing comprises electrically insulating material.
12. device as claimed in claim 11, wherein:
Described electrically insulating material comprises polymeric material.
13. device as claimed in claim 12, wherein:
Described polymeric material comprises fluorinated polymer.
14. device as claimed in claim 13, wherein:
Described fluorinated polymer comprises politef.
15. device as claimed in claim 10, wherein:
Described housing is connected to described bar.
16. device as claimed in claim 15, wherein:
Described housing comprises the near-end cylindrical portions may; And
Be assembled in the inner chamber of described bar by the near-end cylindrical portions may with described housing, described housing is connected to described bar.
17. device as claimed in claim 1, wherein:
Described first semicircular electrode and described second semicircular electrode separate each other by electrical insulator.
18. device as claimed in claim 1, wherein:
The disc far-end of described device also comprises the electrical insulator between described first semicircular electrode and described second semicircular electrode.
19. device as claimed in claim 1, wherein:
Described at least one fluid issuing is positioned on the distal portions of described device near the far-end of described device.
20. device as claimed in claim 1, wherein:
Described at least one fluid issuing is formed in the electrically insulating material.
21. device as claimed in claim 1, wherein:
Described at least one fluid issuing is provided by the housing that described first semicircular electrode and described second semicircular electrode are fixed to described device.
22. device as claimed in claim 1, wherein:
Described first electrode comprises first electrode, first bight and first electrode, second bight; And
Described at least one fluid issuing is located the most close described first electrode in one of described first electrode, first bight and described first electrode second bight.
23. device as claimed in claim 1, wherein:
Described first electrode comprises first electrode, first bight and first electrode, second bight; And
One of contiguous described first electrode, first bight of described at least one fluid issuing and described first electrode second bight.
24. device as claimed in claim 23, wherein:
Described second electrode comprises second electrode, first bight and second electrode, second bight; And
In contiguous described first electrode of described at least one fluid issuing first bight, described first electrode second bight, described second electrode, first bight and described second electrode second bight at least one.
25. device as claimed in claim 1, wherein:
The semicircle perimembranous of described first electrode extends to first electrode, second bight from first electrode, first bight; And
Described at least one fluid issuing is located the most close described first electrode in one of described first electrode, first bight and described first electrode second bight.
26. device as claimed in claim 1, wherein:
The semicircle perimembranous of described first electrode extends to first electrode, second bight from first electrode, first bight; And
One of contiguous described first electrode, first bight of described at least one fluid issuing and described first electrode second bight.
27. device as claimed in claim 26, wherein:
Described second electrode comprises second electrode, first bight and second electrode, second bight; And
In contiguous described first electrode of described at least one fluid issuing first bight, described first electrode second bight, described second electrode, first bight and described second electrode second bight at least one.
28. device as claimed in claim 1, wherein:
Described at least one fluid issuing comprises a plurality of fluid issuings.
29. device as claimed in claim 1, wherein:
Described at least one fluid issuing comprises at least two fluid issuings.
30. device as claimed in claim 29, wherein:
Described at least two fluid issuings are positioned on the relative both sides of described device.
31. device as claimed in claim 29, wherein:
Described at least two fluid issuings comprise the first fluid outlet and second fluid issuing;
Described fluid passage comprises the length that exports to described second fluid issuing from described first fluid; And
Described fluid passage is linear along its length.
32. device as claimed in claim 1, wherein:
Described fluid passage comprises the inner chamber of pipe.
33. device as claimed in claim 32, wherein:
Described inner chamber comprises the inner chamber of polymer pipe.
34. device as claimed in claim 1, wherein:
Described fluid passage comprises at least one hole in the housing, and described housing is fixed to described device with described first semicircular electrode and described second semicircular electrode.
35. device as claimed in claim 34, wherein:
Described at least one hole in the described housing comprises first hole in the described housing and second hole in the described housing; And
Described first hole is intersected with each other with described second hole and vertical mutually.
36. device as claimed in claim 34, wherein:
Described fluid passage comprises the T shape hole in the described housing.
37. device as claimed in claim 1, wherein:
Described bar comprises metallic rod.
38. device as claimed in claim 37, wherein:
Described metallic rod comprises rustless steel.
39. device as claimed in claim 1, wherein:
Described bar has knuckle.
Applications Claiming Priority (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US89676807P | 2007-03-23 | 2007-03-23 | |
| US60/896,768 | 2007-03-23 | ||
| PCT/US2008/057815 WO2008118777A2 (en) | 2007-03-23 | 2008-03-21 | Surgical devices and methods of use thereof |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CN101677812A true CN101677812A (en) | 2010-03-24 |
| CN101677812B CN101677812B (en) | 2013-06-12 |
Family
ID=39789243
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN200880014088.5A Expired - Fee Related CN101677812B (en) | 2007-03-23 | 2008-03-21 | Surgical devices and methods of use thereof |
Country Status (6)
| Country | Link |
|---|---|
| US (2) | US8216233B2 (en) |
| EP (1) | EP2129313B1 (en) |
| JP (1) | JP5430409B2 (en) |
| CN (1) | CN101677812B (en) |
| ES (1) | ES2394719T3 (en) |
| WO (1) | WO2008118777A2 (en) |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103153221A (en) * | 2010-06-30 | 2013-06-12 | 美敦力先进能量有限公司 | Electrosurgical device with a u-shaped electrode and/or coplanar electrodes |
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Also Published As
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| ES2394719T3 (en) | 2013-02-05 |
| JP2010522045A (en) | 2010-07-01 |
| WO2008118777A3 (en) | 2008-11-20 |
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| EP2129313B1 (en) | 2012-08-15 |
| EP2129313A2 (en) | 2009-12-09 |
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| US20080234674A1 (en) | 2008-09-25 |
| CN101677812B (en) | 2013-06-12 |
| US8348946B2 (en) | 2013-01-08 |
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